: Young women who smoke face serious health risks, yet rarely seek help. Brief clinician interventions in smoking are effective but underutilized. The co-variation between smoking and drinking behaviors provides an opportunity to segment populations, allowing us to develop targeted messages to patients and providers to stimulate supply and demand for prevention counseling. The Iong-term goals are to improve the manner in which primary care providers (PCPs) stimulate behavior change. The immediate goals are to increase the number and quality of brief clinician interventions delivered to young women who smoke or problem drink, and to facilitate patients' receptivity to and follow-through of these messages, by developing a tailored web-based technology, Delivering Effective Brief Behavioral Interventions (DEBBI), that generates tailored counseling messages for patients and PCPs, testing it in 3 different primary care settings. The Specific Aims are to 1) Develop and optimize DEBBI, 2) Evaluate the impact of DEBBI on patients, clinicians, and medical errors. We propose a 2-phase study, conducted over 3 years. Part I will use focus groups to segment women based on their smoking and drinking behaviors, identify effective brief physician interventions and patient feedback for each segment, and program and test a stand-alone software program that can be accessed through the Internet to deliver brief tailored messages to both patients and clinicians. Part II will formally evaluate the impact of DEBBI in a randomized, controlled, multi-center trial involving diverse patient populations and clinician settings. We will measure the impact of DEBBI on the delivery of brief counseling messages by PCPs to patients, its impact on patient stage of change for smoking, and its impact on the use of drugs that interact with tobacco or alcohol. This project should develop an innovative approach to stimulating health behavior change in the primary care setting that addresses both patient demand for interventions and PCP supply, drawing upon proven effective techniques (brief, tailored clinician interventions), and that should decrease smoking and risky alcohol use among young women.